Medicare AdvantageCoverageMedium impact
MA08.018k, Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.018k for Trastuzumab (Herceptin) and related biosimilars, including Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) has been updated effective October 1, 2025. This affects billing and coverage guidelines for these cancer treatment medications under Medicare Advantage plans.
Action Required
By October 1, 2025: Billing team should review the complete updated policy MA08.018k for any changes to prior authorization requirements, coverage criteria, or billing guidelines for Trastuzumab (Herceptin) and biosimilar products. Verify current billing procedures align with updated Medicare Advantage requirements for these oncology medications.